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Zhou L, Qiao C, Huang J, Lin J, Zhang H, Xie J, Yuan Y, Hu C. The Impact of Recent Life Events, Internalizing Symptoms, and Emotion Regulation on the Severity of Non-Suicidal Self-Injury in Adolescents: A Mediation Analysis. Neuropsychiatr Dis Treat 2024; 20:415-428. [PMID: 38469207 PMCID: PMC10926171 DOI: 10.2147/ndt.s444729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024] Open
Abstract
Background Previous studies have demonstrated a strong association between recent stressful life events and non-suicidal self-injury (NSSI) among adolescents. Internalizing symptoms and difficulty in emotion regulation (DER) may mediate this relationship. This study aimed to investigate the relationship between recent stressful life events and NSSI severity in adolescents and the potential moderating role of internalizing symptoms and DER. Methods A total of 224 adolescent inpatients (78.6% female) participated in the study, with an age range of 12-18 years old. Data on recent stressful life events, internalizing symptoms, DER, and NSSI behaviors were collected using a clinician-rated questionnaire. A structural equation model was used to test the hypothesized model. Results The rate of NSSI reporting among adolescents in the past 12 months was 65.18%. Recent stressful life events were found to be directly associated with NSSI severity (β = 0.128, P = 0.023). A chain-mediating effect between recent stressful life events and NSSI was also confirmed (β = 0.034, P = 0.023), with DER and internalizing symptoms playing a chain-mediating role and DER having a significantly indirect association with NSSI through internalizing symptoms. Conclusion Recent stressful life events appear to play a role in the etiology of NSSI, particularly punishment and interpersonal relationship events that warrant special attention. DER and internalizing symptoms play a chain-mediating role in the relationship between life events and NSSI. Reducing recent stressful life events, screening for internalizing symptoms, and improving emotion regulation may decrease NSSI behavior among adolescents.
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Affiliation(s)
- Linqi Zhou
- School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Changyuan Qiao
- School of the Fourth Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Jialing Huang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian Lin
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Haisheng Zhang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Jian Xie
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Changchun Hu
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medicine, Hangzhou, People’s Republic of China
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Jin MK, Wang XY, Wang RX, Cheng SY, Yang SY, Zhang SL, Lv SB. A systematic review and meta-analysis of factors related to non-suicidal self-injury among Chinese adolescents. Psychiatry Res 2023; 326:115329. [PMID: 37437488 DOI: 10.1016/j.psychres.2023.115329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/26/2022] [Accepted: 07/01/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Over the past several decades the prevalence of adolescent non-suicidal self-injury (NSSI) has been rising steadily. Understanding the factors associated with NSSI is a critical public health concern. The current study aims to explore the critical factors related to NSSI among Chinese adolescents. METHODS A systematic literature search was conducted to identify the studies meeting our eligibility criteria (published until June 2022) in PubMed, Web of Science, Science Direct, Springer Link, CNKI, VIP, and Wanfang data. The meta-package of R language was used to perform a meta-analysis to compute the pooled effect (r). RESULTS A total of 59 studies were included in this analysis, with a sample size of 192,546. Twenty-four democratic, personal, and social factors were examined in current study. The pooled effect value (r) has revealed that 23 factors are associated with NSSI behaviors among Chinese adolescents. The factor, Internet addiction, has demonstrated the greatest association with NSSI compared to other factors. CONCLUSION Consistent with previous studies on adolescent NSSI, findings have demonstrated that a number of demographic, personal, and social factors significantly contribute to NSSI behaviors among Chinese adolescents. Future research on prevention and intervention for adolescent NSSI may benefit from targeting these factors.
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Affiliation(s)
- Meng-Ke Jin
- School of Psychology and Mental Health, Tangshan Key Laboratory of Mental Health and Cognitive Neuroscience, Tangshan Basic Innovation Team for Brain and Cognitive Function Research, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan 063210, PR China
| | - Xiao-Yan Wang
- Library, North China University of Science and Technology, Tangshan, PR China
| | - Rui-Xin Wang
- School of Psychology and Mental Health, Tangshan Key Laboratory of Mental Health and Cognitive Neuroscience, Tangshan Basic Innovation Team for Brain and Cognitive Function Research, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan 063210, PR China
| | - Shu-Ying Cheng
- School of Psychology and Mental Health, Tangshan Key Laboratory of Mental Health and Cognitive Neuroscience, Tangshan Basic Innovation Team for Brain and Cognitive Function Research, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan 063210, PR China
| | - Shi-Ying Yang
- School of Psychology and Mental Health, Tangshan Key Laboratory of Mental Health and Cognitive Neuroscience, Tangshan Basic Innovation Team for Brain and Cognitive Function Research, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan 063210, PR China
| | - Shi-Lei Zhang
- Hui Hua College of Hebei Normal University, Shijiazhuang, PR China
| | - Shao-Bo Lv
- School of Psychology and Mental Health, Tangshan Key Laboratory of Mental Health and Cognitive Neuroscience, Tangshan Basic Innovation Team for Brain and Cognitive Function Research, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan 063210, PR China.
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Pisano T, Gori S, De Luca L, Fiorentini G, Minghetti S, Nocentini A, Menesini E. Peer victimization and developmental psychopathology in childhood and adolescence Italian psychiatric emergency unit. A single center retrospective observational study. PSYCHOL HEALTH MED 2023; 28:2147-2155. [PMID: 32816557 DOI: 10.1080/13548506.2020.1810721] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
Peer victimization is a public health concern that affects a significant proportion of children and adolescents. The study evaluated the prevalence of peer victimization among 440 subjects referred to Emergency Department for a psychiatric consultation and analyzed the association with psychopathological symptoms. Sample was divided into two categories (6-13 and 14-18 years old). Logistics regression analysis was performed. Peer victimized were reported in 16.3% of subjects; 27.7% were younger than13 years old and 72.3% were between 14-18 years old, representing the main targets for peer victimization.A significant association was found between being peer victimized and depressive disorder (OR=4.57) in subjects younger than 13 years old and, with post-traumatic stress disorder (PTSD)(OR=6.52) in subjects older than 13 years old. Furthermore, linkage between being peer victimized and obsessive-compulsive disorder (OCD)(OR=4.45) was noted. Increased frequency of repeated hospitalizations was also documented.This is the first Italian study about children and adolescent peer victimization in psychiatric setting, showing a significant higher risk for depressive disorder in subjects younger than 13 years old and PTSD and OCD in subjects older than 13 years old. Investigating experiences of peer victimization provides an early diagnosis and a more efficient treatment plans, guaranteeing an improved clinical outcome.
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Affiliation(s)
- Tiziana Pisano
- Child and Adolescent Psychiatry Unit, A. Meyer Children's Hospital, Florence, Italy
| | - Sara Gori
- Child and Adolescent Psychiatry Unit, A. Meyer Children's Hospital, Florence, Italy
| | - Lisa De Luca
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
| | - Giada Fiorentini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
| | - Sara Minghetti
- Child and Adolescent Psychiatry Unit, A. Meyer Children's Hospital, Florence, Italy
| | - Annalaura Nocentini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
| | - Ersilia Menesini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
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Gupta N, Gupta M, Madabushi JS, Zubiar F. Integrating Psychosocial Risks With Emerging Evidence for Borderline Personality Disorders in Adolescence: An Update for Clinicians. Cureus 2023; 15:e40295. [PMID: 37448386 PMCID: PMC10337505 DOI: 10.7759/cureus.40295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Borderline personality disorder (BPD) has seen significant advances in the knowledge of its developmental phenomenology during late childhood and adolescence. Various genetic, neurobiological, psychological, and social factors are implicated in the etiology of BPD. With emerging evidence on BPD development in adolescence, the review focused on recent literature to understand the role of psychosocial risk factors. The effects of adverse familial environment, physical, emotional, verbal, and sexual abuse, intergenerational transmission of psychopathological traits, maternal neglect and rejection, low socioeconomic status, bullying victimization, and dating violence were reviewed to understand their role in the development of BPD. BPD is a highly complex, serious, and enduring mental illness that has now been widely accepted to have symptoms that onset in early adolescence and could be diagnosed as early as age 12. BPD symptoms are stable, phenomenologically distinct from externalizing and internalizing disorders, and often present with co-occurring disorders, which during assessment could not explain impairments associated with BPD. New measures like the Difficulties in Emotion Regulation Scale (DERS), detailed developmental histories, understanding of psychosocial risks, shared decision-making, and psychoeducation could assist in early diagnosis and improvement of long-term outcomes. The implementation of evidence-based treatments is a challenge given higher costs and access to services; therefore, modifications in the treatment based on the core principles of these strategies should be considered. It is imperative to screen for psychosocial factors early in higher-risk groups. The assessment of familial factors, parental histories of psychopathologies, and histories of childhood abuse is important in context with impairing symptoms of clinical presentation and dimensional aspects of self-functioning. The role of family therapies, parental psychoeducation, and the integration of trauma-informed care approaches are important for clinical outcomes. Also, coordinated efforts with multiple stakeholders like school awareness programs, anti-bullying policies, legislation, and enforcement of existing laws might be instrumental in addressing issues related to victimization by peers.
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Affiliation(s)
- Nihit Gupta
- Psychiatry, University of West Virginia, Glen Dale, USA
| | - Mayank Gupta
- Psychiatry and Behavioral Sciences, Southwood Psychiatric Hospital, Pittsburgh , USA
| | | | - Faiza Zubiar
- Psychiatry, The Trenton Psychiatric Hospital, Trenton, USA
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Xiao Y, Ran H, Che Y, Fang D, Wang S, Chen L, Liang X, Peng J, Sun H, Li Q, Shi Y, Lu J. Childhood maltreatment and parenting style associated school bullying in Chinese children and adolescents: An analytical epidemiology evidence. J Affect Disord 2023; 331:386-392. [PMID: 36990285 DOI: 10.1016/j.jad.2023.02.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE The independent associations among childhood maltreatment (CM), parenting style, and school bullying in children and adolescents have not been adequately discussed. Epidemiological evidence of higher quality is still scarce. We intend to investigate this topic by using a case-control study design in a large sample of Chinese children and adolescents. METHOD Study participants were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega ongoing cross-sectional study. The combined database from four study sites was used. The population-based case-control study was individually matched by study site, age, sex, race, left-behind status, whether a single child, and whether a boarding student. RESULTS Cases were observed to have a significantly higher prevalence of CM, higher scores for parental rejection and over-protection, and lower scores for parental emotional warmth. Multiple conditional logistic regression revealed that CM, especially emotional abuse (EA) and sexual abuse (SA), were associated with a prominently increased risk of school bullying involvement, with adjusted odds ratio (OR) of 2.28 (95 % CI: 2.03, 2.57) and 1.90 (95 % CI: 1.67, 2.17). Subsequent analysis further corroborated the robustness of EA-bullying and SA-bullying associations. Although parenting style generally showed a weaker association with school bullying, a higher level of parental rejection was related to an increased risk of bullying victimization. CONCLUSIONS Chinese children and adolescents who are victims of EA or SA, or experienced a higher level of parental rejection, are more vulnerable to school bullying. Targeted interventions should be designed and implemented.
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Affiliation(s)
- Yuanyuan Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China; Key Library in Public Health and Disease Prevention and Control, Yunnan Provincial Department of Education, China
| | - Hailiang Ran
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yusan Che
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Die Fang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Sifan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Lin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xuemeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Junwei Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Hao Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Qiongxian Li
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yuanyu Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jin Lu
- Psychiatry Department, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China; Mental Health Institute of Yunnan, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China; Yunnan Clinical Research Center for Mental Health, Kunming, Yunnan, China.
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The Role of Cognitive Deficits in Borderline Personality Disorder with Early Traumas: A Mediation Analysis. J Clin Med 2023; 12:jcm12030787. [PMID: 36769436 PMCID: PMC9917894 DOI: 10.3390/jcm12030787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
(1) Background: although studies of cognitive functions are still limited in borderline personality disorder (BPD), the initial evidence suggested that BPD patients have deficits of executive functions and social cognition. In addition, patients who report physical and psychic traumatic experiences in childhood and adolescence show considerable neurocognitive impairment and severe BPD symptoms. The present study has a twofold aim: (1) to evaluate the differences in neurocognitive performances between BPD patients and healthy controls and (2) to verify in the BPD patients group whether neurocognitive deficits have the role of mediating the effect of early traumas on BPD psychopathology. (2) Methods: 69 subjects were enrolled: 38 outpatients with a diagnosis of BPD (DSM-5) and 31 healthy controls. BPD patients were tested with the Borderline Personality Disorder Severity Index (BPDSI), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). All subjects were evaluated with the Iowa Gambling task (IGT), the Berg card sorting test (BCST), the Tower of London task (ToL), and the Reading-the-mind-in-the-eyes-test (RMET). Statistical analysis was performed with the analysis of variance to compare the cognitive performances between BPD patients and controls. A mediation analysis was conducted with the Sobel Test in the BPD patients group. The significance level was p ≤ 0.05. (3) Results: significant differences between the two groups were found for several parameters of all the cognitive tests examined: BCST, IGT, ToL, and RMET. Mediation analysis with the Sobel test demonstrated that the percentage of correct answers in the BCST (BCSTc) and the RMET score significantly mediated the relation between the CTQ total score and BPDSI total score. (4) Conclusions: BPD patients showed an impairment of the following executive functions: set shifting, decision making, planning and problem solving, and social cognition abilities, in comparison with controls. Our results suggested that the effect of early trauma on BPD psychopathology was mediated by a deficit in two cognitive domains: cognitive flexibility and social cognition.
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Seiffert N, Cavelti M, Josi J, Reichl C, Koenig J, Mürner-Lavanchy I, Kaess M. Zusammenhang zwischen unterschiedlichen Mobbingerfahrungen und der Ausprägung von Borderline-Persönlichkeitsstörungsmerkmalen bei Jugendlichen in der Kinder- und Jugendpsychiatrie. KINDHEIT UND ENTWICKLUNG 2023. [DOI: 10.1026/0942-5403/a000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Zusammenfassung: Theroretischer Hintergrund: Die vorliegende Studie untersucht den Zusammenhang zwischen Mobbing(–Arten) und der Ausprägung der Borderline-Persönlichkeitsstörung (BPS) bei Jugendlichen. Methode: 513 konsekutiv rekrutierte, jugendliche Patient_innen nahmen an einer umfassenden Diagnostik teil. Der Zusammenhang zwischen der Häufigkeit von Mobbingerfahrungen und der Anzahl der BPS-Kriterien wurde mit Hilfe von ordinalen logistischen Regressionen untersucht. Ergebnisse: Jugendliche Patient_innen, die in den vergangenen drei Monaten mehrmals pro Woche gemobbt wurden, wiesen eine stärkere BPS-Symptomatik auf als Jugendliche ohne Mobbingerfahrung (OR = 3.47, CI = 2.32 – 5.18, p < 0.001). Soziales Mobbing und Bedrohen erwiesen sich als wichtigste Prädiktoren für den Schweregrad der BPS-Symptomatik. Diskussion und Schlussfolgerung: Häufigere Mobbingerfahrungen, insbesondere sozialer und bedrohender Art, waren mit mehr Symptomen der BPS assoziiert. Programme zur Prävention von Mobbing an Schulen sollten gefördert sowie in der Behandlung von Patienten thematisiert werden.
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Affiliation(s)
- Nora Seiffert
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Marialuisa Cavelti
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Johannes Josi
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Corinna Reichl
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Julian Koenig
- Medizinische Fakultät, Universität Köln, und Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Köln, Deutschland
| | - Ines Mürner-Lavanchy
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Michael Kaess
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
- Klinik für Kinder- und Jugendpsychiatrie, Zentrum für psychosoziale Medizin, Universitätsklinikum Heidelberg, Deutschland
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Roques M, Spiers S, El Husseini M, Drieu D, Laimou D, de Kernier N, Mazoyer AV, Guénolé F. The experience of bullying among adolescents receiving mental health care: an interpretative phenomenological analysis. Child Adolesc Psychiatry Ment Health 2022; 16:69. [PMID: 35987651 PMCID: PMC9392925 DOI: 10.1186/s13034-022-00505-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Bullying, the most prevalent form of abuse among adolescents, is associated with emotional and behavioural problems as well as psychiatric morbidity. Moreover, it has been shown that adolescents with previous mental health problems are at increased risk of being bullied and that the psychopathological repercussions of bullying are greatest among them. However, little is known about the experience of bullying in adolescents receiving treatment from mental health services. The aim of this study was to explore the subjective experience of bullying in adolescents receiving mental health care. METHODS The study was developed in the context of a French multicentre research program and employed an exploratory phenomenological approach. A purposeful sampling strategy was used to select adolescents who had experienced bullying (according to the Olweus criteria) and who were able to relate their experiences clearly. In-depth, semistructured interviews with participants were conducted; written transcriptions of these interviews were analysed using thematic analysis. RESULTS Twenty-one adolescents (age range: 12-17 years; 13 girls) participated in the study. The analysis indicated a three-axis structure: (1) negative emotions and violent feelings, describing adolescents' fear, sadness, aggression against themselves, and generalized mistrust; (2) isolation and loneliness, underlining the need to take refuge within oneself and the experiences of rejection, helplessness, and secret-keeping; and (3) self and identity repercussions, including experiences of shame and lowered self-esteem, identity questions, and a vision of bullying as a life experience. CONCLUSIONS The results of this study may have practical implications for clinicians: (1) a situation of bullying should be sought when an adolescent is seen for unexplained externalized behavioural misconduct; (2) low levels of emotional expression in a bullied adolescent may warn about associated self-harm; (3) a bullied adolescent's tendency to hide this situation from his or her parents may reflect underlying family-related vulnerability; and (4) the phenomenological analysis showed potential particularities in the assumptive world of these adolescents and suggested that relationality may play a crucial role in their experiences. These results suggest incentives to design specific individual and group therapeutic interventions for bullied adolescents with significant levels of social withdrawal, including family support. Additional research is necessary to improve our understanding of the psychopathological and intersubjective aspects of bullying in adolescents.
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Affiliation(s)
- Marjorie Roques
- grid.5613.10000 0001 2298 9313Université de Bourgogne, PSY-DREPI (EA-7458), Dijon, France
| | - Solène Spiers
- grid.420146.50000 0000 9479 661XPôle de Psychiatrie de l’enfant et de L’adolescent, Centre Hospitalier Le Vinatier, Bron, France
| | - Mayssa’ El Husseini
- grid.11162.350000 0001 0789 1385Université de Picardie Jules Verne, CHSSC (EA-4289), Amiens, France
| | - Didier Drieu
- grid.10400.350000 0001 2108 3034Université de Rouen Normandie, CRFDP (EA-7475), Rouen, France
| | - Dimitra Laimou
- grid.11162.350000 0001 0789 1385Université de Picardie Jules Verne, CHSSC (EA-4289), Amiens, France
| | - Nathalie de Kernier
- grid.508487.60000 0004 7885 7602Université Paris-Nanterre, CLIPSYD (EA-4430), Nanterre, France
| | | | - Fabian Guénolé
- Service de Psychiatrie de l'enfant et de L'adolescent, CHU de Caen, Université Caen Normandie, 14 Avenue Clemenceau, 14033, Caen cedex 9, France.
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Relationships of Homophobic Bullying Victimization during Childhood with Borderline Personality Disorder Symptoms in Early Adulthood among Gay and Bisexual Men: Mediating Effect of Depressive Symptoms and Moderating Effect of Family Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084789. [PMID: 35457655 PMCID: PMC9027503 DOI: 10.3390/ijerph19084789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 02/04/2023]
Abstract
This study investigated (1) the associations of homophobic bullying victimization in childhood with borderline personality disorder (BPD) symptoms in early adulthood among gay and bisexual men; (2) the mediating effect of depressive symptoms on the association between homophobic bullying victimization and BPD symptoms, and (3) the moderating effects of perceived family support on the association between homophobic bullying victimization and BPD symptoms. A total of 500 gay or bisexual men aged between 20 and 25 years were recruited into this study. The experiences of physical, verbal and social relationship bullying victimization during childhood were evaluated using the Mandarin Chinese version of the School Bullying Experience Questionnaire. The experiences of cyberbullying victimization during childhood were evaluated using the Cyberbullying Experiences Questionnaire. BPD symptoms were assessed using the Borderline Symptom List. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale. Perceived family support was evaluated using the Family Adaptation, Partnership, Growth, Affection, and Resolve index. The results of mediation analyses demonstrated that all the types of homophobic bullying victimization in childhood were directly associated with BDP symptoms in young adulthood as well as indirectly associated with BPD symptoms through the mediation of depressive symptoms. The results of moderation analyses demonstrated that the association between homophobic bullying victimization and BPD symptoms decreased when the individuals had more family support. Intervention programs to reduce homophobic bullying victimization and enhance family support for gay and bisexual men and their families are necessary. Interventions to improve depressive and BPD symptoms among gay and bisexual men are also necessary, especially for those who experienced homophobic bullying victimization during childhood.
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10
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Yang F, Jiang L, Miao J, Xu X, Ran H, Che Y, Fang D, Wang T, Xiao Y, Lu J. The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China. PeerJ 2022; 10:e12665. [PMID: 35287346 PMCID: PMC8917796 DOI: 10.7717/peerj.12665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/30/2021] [Indexed: 01/07/2023] Open
Abstract
Background The association between negative life events and Non-suicidal self-injury (NSSI) in children and adolescents has been extensively discussed. Nevertheless, little is known about the relationship between negative life events and repetition and severity of NSSI. This survey aims to understand the association between NSSI prevalence, severity, repetition and the negative life events in children and adolescents in underdeveloped regions in south-western China. Methods In this population-based cross-sectional study, 3,146 children and adolescents were included from underdeveloped regions of south-western China, and each of them requested to complete a self-assessment questionnaire. The Modified Version of Adolescents Self-Harm Scale (MASHS) and the Adolescent Self-rating negative Life Events Check-list were used to evaluate NSSI behaviors and negative life events, respectively. The statistical implementation of this study was carried out in the R statistical software, and the logistic regression analysis method was used to analyze the relationship between negative life events and adolescents' non-suicidal self-injury behaviors. Results The average age of all included participants was 13.31 years old. The lifetime prevalence of NSSI was 47.0% (95% CI [36.3-58.0%]). Gender, grade level and ASLEC was positively associated with NSSI. Further analysis revealed that, for all five dimensions of ASLEC, only interpersonal relationship factor (IRF) (OR 1.77 (95% CI [1.06-2.97])), health adaptation factor (HAF) (OR 2.08 (95% CI [1.31-3.31])) showed prominent association with NSSI. Multivariate Logistic regression models revealed that, repetitive NSSI (OR 4.54 (95% CI [3.66-5.63])) and NSSI severity (OR 9.01 (95% CI [6.11-13.29])) were positively associated with ASLEC. Conclusion NSSI is very common among children and adolescents in underdeveloped regions of south-western China. Negative life event are positively associated with NSSI, repeated NSSI, and severe NSSI. Negative life events centered intervention measures might be effective in reducing NSSI among school children and adolescents in underdeveloped regions of south-western China.
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Affiliation(s)
- Fan Yang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Linling Jiang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Jing Miao
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Xiufeng Xu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Hailiang Ran
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Yusan Che
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Die Fang
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - TianLan Wang
- Lincang Psychiatric Hospital, Lincang, Yunnan, China
| | - Yuanyuan Xiao
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Jin Lu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
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11
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School bullying associated suicidal risk in children and adolescents from Yunnan, China: The mediation of social support. J Affect Disord 2022; 300:392-399. [PMID: 34998803 DOI: 10.1016/j.jad.2022.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to investigate the mediation of social support in the association between school bullying and suicidal risk among a large group of Chinese children and adolescents. METHOD In this two-wave cross-sectional study, we analyzed 6,063 children and adolescents from southwest China. A two-stage simple random clustering sampling method with probability proportionate to sample size design had been used to select study subjects. Univariate and multivariate Logistic regression models were adopted to determine the inter-associations between school bullying, suicidal risk indicators, and social support. Path models were further fitted to estimate the mediation of social support. RESULTS Compared with students who were not involved in school bullying, only victimization was associated with increased suicidal risk, the adjusted ORs for suicidal ideation, suicidal plan, and suicidal attempt were 2.06 (95% CI: 1.61-2.65), 2.07 (95% CI: 1.62-2.64), and 2.41 (95% CI: 1.90-3.05), respectively. Path model indicated that parental social support significantly mediated the association between bullying victimization and suicidal risk. For different types of victimization, only relational bullying victimization was associated with increased suicidal risk, social support from classmates and close friends presented as significant mediators. LIMITATIONS Causal inference cannot be made because of cross-sectional study design. Information was collected by using self-reporting method, the possibility of information bias exists. Generalization of study results could be limited. CONCLUSIONS Intervention measures on improving parental and peer social support may be effective in reducing school bullying victimization associated suicidal risk for Chinese children and adolescents.
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12
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Borderline Personality Disorder: Risk Factors and Early Detection. Diagnostics (Basel) 2021; 11:diagnostics11112142. [PMID: 34829488 PMCID: PMC8620075 DOI: 10.3390/diagnostics11112142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 12/13/2022] Open
Abstract
Personality disorders (PDs) exert a great toll on health resources, and this is especially true for borderline personality disorder (BPD). As all PDs, BPD arises during adolescence or young adulthood. It is therefore important to detect the presence of this PD in its earlier stages in order to initiate appropriate treatment, thus ameliorating the prognosis of this condition. This review aims to highlight the issues associated with BPD diagnosis in order to promote its early detection and treatment. To do so, we conducted a search on PubMed database of current evidence regarding BPD early diagnosis, focusing on risk factors, which represent important conditions to assess during young patient evaluation, and on diagnostic tools that can help the clinician in the assessment process. Our findings show how several risk factors, both environmental and genetic/neurobiological, can contribute to the onset of BPD and help identify at-risk patients who need careful monitoring. They also highlight the importance of a careful clinical evaluation aided by psychometric tests. Overall, the evidence gathered confirms the complexity of BDP early detection and its crucial importance for the outcome of this condition.
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Mao A, Tam HL, Cheong PL, Van IK. "You Need to Get Over the Difficulties and Stand Up Again"-A Qualitative Inquiry into Young Nurses' Coping with Lateral Violence from the Feminist Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137167. [PMID: 34281104 PMCID: PMC8297138 DOI: 10.3390/ijerph18137167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022]
Abstract
Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring professional identity development in different professional stages was conducted by a research team in Macau, Special Administrative Region of China. Semi-structured interviews with nursing students and clinical nurses were carried out; among the 58 participants in the three sub-studies, 20 described some forms of LV and their ways of dealing with them. Framed by the feminist perspective, the researchers explored young nurses’ coping strategies in dealing with LV perpetrated by senior colleagues. Two themes were developed reflecting the coping strategies for LV: “making extra efforts” and “soothing emotional distress”. Three sub-themes were under the theme of “making extra efforts”: “catching up knowledge”, “making the most use of learning resources”, “adjusting communication manner”; another batch of sub-themes was under the theme of “soothing emotional distress”: “seeking support from schoolmates”, “living with family but crying alone”, and “adjusting lifestyle”. The study implied that young nurses exerted their agency in coping with LV in clinical practices. Nursing managers and educators should support young nurses’ efforts in overcoming power-based LV and incivility.
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Affiliation(s)
- Aimei Mao
- Correspondence: ; Tel.: +853-85906391
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14
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Oulasmaa LE, Riipinen PK, Hakko HH, Riala KR. Role of involvement in bullying as predictor for hospital-treated assault exposures among former adolescent psychiatric inpatients. Int J Psychiatry Med 2021; 56:189-204. [PMID: 33322984 DOI: 10.1177/0091217420982101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Bullying is a common problem among children and adolescents. Previous studies have investigated the associations between involvement in bullying and various psychosocial and mental health outcomes thoroughly. However, only few studies have focused on the association between bullying and exposure to assaults. This study investigated whether the likelihood for severe assault exposure varies among three subgroups of bullying behavior: bullies/bully-victims, victims of bullying, and those not involved in bullying. METHOD The study population consisted of 508 adolescents (208 boys, 300 girls) aged between 13 and 17 years (mean age 15.5 years), admitted for psychiatric inpatient treatment between the years 2001-2006. Adolescents were interviewed at index hospitalization using semi-structured interview, K-SADS-PL, to assess DSM-IV based adolescent psychiatric disorders, and to obtain information on bullying behavior. Treatment episodes for assault incidents were obtained from the Finnish National Care Register for Health Care covering the entire-life of the study participants up to end of year 2016. RESULTS 14.4% (n = 73) of the study participants had experienced severe physical or sexual assault leading to hospital treatment during their lifetime. Results of Cox regression analysis showed that girl bullies/bully-victims had nearly threefold increased likelihood for later assault exposure. CONCLUSIONS Since bullying behavior in childhood and adolescence is a significant predictor for later exposure to severe assault in girls, it should be paid attention to and intervened as early as possible. Moreover, psychosocial risk factors should be taken into account considering those in hospital treatment for severe assault exposure.
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Affiliation(s)
- Lauri E Oulasmaa
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Pirkko K Riipinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Helinä H Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Kaisa R Riala
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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15
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Ran H, Cai L, He X, Jiang L, Wang T, Yang R, Xu X, Lu J, Xiao Y. Resilience mediates the association between school bullying victimization and self-harm in Chinese adolescents. J Affect Disord 2020; 277:115-120. [PMID: 32810666 DOI: 10.1016/j.jad.2020.07.136] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/26/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The association between school bullying and self-harm (SH) in adolescents has been extensively discussed. Nevertheless, little is known about the mechanism of this relationship, particularly the role of resilience. Our research aimed to explore and evaluate the potential moderation and mediation of resilience in the association between school bullying victimization and SH in a large sample of Chinese adolescents. METHOD We conducted a population-based cross-sectional survey of 3146 adolescents in southwest China. The data were collected by a self-administered questionnaire. Multivariate Logistic regression which incorporated the product term of bullying victimization and resilience was used to estimate the moderation of resilience. Mediation of resilience in bullying victimization and SH were evaluated by path model. RESULTS The prevalence of bullying involvement and SH were 13.13% (95% CI:9.31%-18.00%) and 47.0% (95% CI: 36.3%-58.0%), respectively. School bullying victimization was positively associated with SH. Resilience was a prominent mediator which accounted for 27.7% of the total association. Among all five dimensions of resilience, emotion regulation (30.90%), interpersonal assistance (24.78%), and family support (22.16%) showed the strongest mediation. Nevertheless, the moderation of resilience in this association was not statistically significant. CONCLUSIONS The findings of the present study suggest that resilience strengthening measures, particularly those aimed at improving emotion regulation ability and building social support could be effective in reducing school bullying victimization related SH behaviors among Chinese teenagers.
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Affiliation(s)
- Hailiang Ran
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Le Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
| | - Xingting He
- Lincang Psychiatry Hospital, Lincang, Yunnan, China
| | - Linling Jiang
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650032, China
| | - Tianlan Wang
- Lincang Psychiatry Hospital, Lincang, Yunnan, China
| | - Runxu Yang
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650032, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650032, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Yuanyuan Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China.
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Bozzatello P, Rocca P, Bellino S. Trauma and psychopathology associated with early onset BPD: an empirical contribution. J Psychiatr Res 2020; 131:54-59. [PMID: 32927365 DOI: 10.1016/j.jpsychires.2020.08.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/13/2020] [Accepted: 08/30/2020] [Indexed: 11/27/2022]
Abstract
Prodromal symptoms of borderline personality disorder (BPD) often arise in young age, especially in early adolescence. Several factors for early BPD onset have been identified to consent a precocious detection of high-risk population. The present study is aimed: (1) to identify what psychopathological, traumatic, and functional factors are significantly associated to early onset in a sample of BPD patients and (2) to evaluate what factors are associated to the time interval between symptoms onset and first psychiatric visit (Δ age). Participants were enrolled from BPD outpatients attending the Center for Personality Disorder of the University of Turin, Italy. Patients were tested with assessment instruments for specific BPD symptoms, exposure to traumatic experiences, global functioning, and perception of quality of life. All variables that were found significant at a bivariate analysis were included in two multiple regressions (stepwise backward), with the age of onset and the Δ age as dependent variables. Significance level was P ≤ 0.05. Seventy patients were included in the study (68 completers). Factors that were found related to age of onset were: CTQ-SF emotional abuse (P = 0.001); ACE-IQ bully victimization (P = 0.005), alcohol/drug abuser in the household (P = 0.001), and physical neglect (P = 0.006); BIS non-planning impulsivity (P = 0.005); and SOFAS score (P = 0.033). Factors that were found related to Δ age were: ACE-IQ total score (P = 0.001) and BIS total score (P = 0.001). Earlier onset of BPD is mainly associated to traumatic events, including abuse, neglect, dysfunction in household environment, and bullying. Earlier onset is also related to a worse social functioning. Among BPD symptoms only non-planning impulsivity was found associated to early onset. A higher number of traumatic events and worse impulsive dyscontrol induce a significant reduction of the time interval between onset and first psychiatric observation.
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Affiliation(s)
| | - Paola Rocca
- Department of Neuroscience, University of Turin, Italy
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17
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Vanwoerden S, Leavitt J, Gallagher MW, Temple JR, Sharp C. Dating violence victimization and borderline personality pathology: Temporal associations from late adolescence to early adulthood. Personal Disord 2019; 10:132-142. [PMID: 30829527 DOI: 10.1037/per0000324] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Borderline personality pathology is a serious mental illness characterized by pervasive interpersonal deficits that onset during adolescence. Risk factors for borderline personality pathology include maladaptive interpersonal dynamics within attachment relationships. Given the shift toward emphasizing romantic relationships during adolescence as an important attachment relationship with implications for healthy development, the current study aimed to evaluate the longitudinal and reciprocal relations between victimization in dating relationships and borderline pathology in the transition from late adolescence to early adulthood. A large sample of high school daters (N = 818; 58% female; Mage = 16.10 years, SDage = .78) were recruited to complete annual assessments of borderline personality features and dating violence victimization across 5 years. Results of a cross-lagged panel model revealed that primarily among girls, borderline features predicted increased levels of relational, psychological, and physical violence, whereas psychological and sexual violence predicted greater borderline features. The current findings provide the first evidence of a longitudinal association between victimization and borderline pathology in adolescence and suggest, particularly among girls, that interventions for borderline features have important implications for reducing dating violence victimization among adolescents and young adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Jeff R Temple
- Department of Obstetrics and Gynecology, University of Texas Medical Branch
| | - Carla Sharp
- Department of Psychology, University of Houston
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18
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Studen-Pavlovich D, Vieira AM. The Dynamics of Change. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00037-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Bozzatello P, Bellino S, Bosia M, Rocca P. Early Detection and Outcome in Borderline Personality Disorder. Front Psychiatry 2019; 10:710. [PMID: 31649564 PMCID: PMC6794381 DOI: 10.3389/fpsyt.2019.00710] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 09/04/2019] [Indexed: 01/24/2023] Open
Abstract
Borderline personality disorder (BPD) is a severe and heterogeneous mental disorder that is known to have the onset in young age, often in adolescence. For this reason, it is of fundamental importance to identify clinical conditions of childhood and adolescence that present a high risk to evolve in BPD. Investigations indicate that early borderline pathology (before 19 years) predict long-term deficits in functioning, and a higher percentage of these patients continue to present some BPD symptoms up to 20 years. There is a general accordance among investigators that good competence in both childhood and early adulthood is the main predictive factor of excellent recovery in BPD patients. Some authors suggest that specific childhood personality traits can to be considered precursors of adult BPD, as well as some clinical conditions: disruptive behaviours, disturbance in attention and emotional regulation, conduct disorders, substance use disorders, and attention-deficit-hyperactivity disorder. Unfortunately, diagnosis and treatment of BPD is usually delayed, also because some clinicians are reluctant to diagnose BPD in younger individuals. Instead, the early identification of BPD symptoms have important clinical implications in terms of precocious intervention programs, and guarantees that young people with personality disorders obtain appropriate treatments. This review is aimed to collect the current evidences on early risk and protective factors in young people that may predict BPD onset, course, and outcome.
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Affiliation(s)
| | - Silvio Bellino
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Marco Bosia
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Paola Rocca
- Department of Neuroscience, University of Turin, Turin, Italy
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Bullying: peer-to-peer maltreatment with severe consequences for child and adolescent mental health. Eur Child Adolesc Psychiatry 2018; 27:945-947. [PMID: 30003397 DOI: 10.1007/s00787-018-1201-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Kawada T. Commentary on "Who is becoming personality disordered? A register-based follow-up study of 508 inpatient adolescents". Eur Psychiatry 2017. [PMID: 28628825 DOI: 10.1016/j.eurpsy.2017.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- T Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.
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